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Introduction: Brachial plexus injury (BPI) is not a common complication of surgery and anesthesia, which may happen with varied mechanisms like over-abduction, no appropriate positioning, and upper limb stretching. The overall prognosis of BPIs is commonly satisfactory, but the poor function of the upper limb may not be fully recovered in all cases and may end in the permanent sequel in serious injuries. Case Presentation: This study reported a woman with breast cancer. She developed a right brachial plexopathy following a modified radical mastectomy. Upon conservative treatment, full recovery was achieved and normal function of the right upper limb was observed 3 months following the operation. Conclusions: The arm's extremely abnormal positioning during intraoperative manipulation and axillary retraction or hyper abduction can lead to BPI. Nerve injury can occur even in diabetic patients, whose blood glucose is well controlled and have no other risk factors. If the nerve structure is intact, spontaneous recovery can be expected with conservative management. [ABSTRACT FROM AUTHOR]

Background: Sodium bicarbonate injection can prevent brain trauma and serious internal problems. Since brain neuronal damage can be caused by an acute event such as hypoxia or cardio-respiratory arrest, prevention of severe acidosis can protect brain cells. Methods: We used Mus Masculus and BALB / C mice weighing 25 -35 g, aged 8 to 12 weeks old, from the Shohada-e-Tajrish Laboratory Animal Center, Tehran, Iran. Sodium bicarbonate (SB) (4meq / kg) was injected to the mice at different times and the rate of immobility and respiratory arrest induced by acute hypoxia was measured. Result: In the study group, we first developed acute hypoxia inside the anesthesia chamber and completed hypoxia by adding CO2. The experimental group underwent acute hypoxia, and showed slightly longer resistance than the control group. Bicarbonate (4meq / kg, IP) was injected to animals 60 min, 6 h, 12 h, and 24 h before acute hypoxia. Conclusion: In this study, SB at doses above 4meq / kg had a significant effect on hypoxia and led increased resistance to acute hypoxia. [ABSTRACT FROM AUTHOR]

Background: Esophageal spasm is a common problem after Foreign Body Ingestion (FBI) and causes difficulties for foreign bodies' removal by endoscopic intervention. Sometimes, medication may help relieve spasms and facilitate the removal of a foreign body. In the current study, we introduce a patient with esophageal spasm due to FBI for whom intravenous nitroglycerin was used to treat the spasm. Methods: The patient was a 48-year-old man who was admitted to emergency department of Shohadaye Tajrish academic Hospital, Tehran, Iran due to FBI and following sever mid-anterior neck pain, nausea and drooling. His vital signs were normal and during endoscopic procedure, we noticed a sharp object attached to the wall of the upper third of the esophagus, causing severe spasm. After trying for an hour to remove the glass under general anesthesia, we were not able to remove it. Finally, intravenous nitroglycerin was used to relieve the spasm and it was easily removed after 2 minutes. Conclusion: Due to inconsistencies in the clinical results of nitroglycerin, and as notable lack of studies are investigating the effectiveness of the intravenous method, we aimed to share our successful experience. [ABSTRACT FROM AUTHOR]

Background and aims: Coronavirus disease 2019 (COVID-19) has posed many challenges for healthcare workers around the world. This study aims to present the most appropriate and evidence-based scientific advice for safe regional anesthesia practice during the COVID-19 pandemic. Methods: To perform regional anesthesia during respiratory disease outbreaks, several databases were investigated, including PubMed, Google Scholar, Up-to-date, and ScienceDirect. Searches were in English during a timeframe spanning from February 15, 2019, until February 15, 2021, and the applied keywords were “COVID-19 anesthesia”, “surgery”, and “operating room” Results: We have focused on definite areas such as workforce and resource planning, modification of clinical setting, preparation of equipment, supplies, and medications, selection of proper personal protective equipment (PPE), cardiorespiratory monitoring of the patient, and sedation and oxygen therapy. Other fields were assessing safe regional anesthesia techniques and monitoring during anesthesia, postanesthesia care, and follow-ups. In these recommendations, keeping the patients safe while protecting healthcare providers from potential exposure to infection is of particular interest. Conclusion: The safety of healthcare workers and patients during the anesthesia management of suspected and positive COVID-19 cases is of utmost importance. Although there is limited evidence regarding performing regional anesthesia, these presented suggestions summarize the best accessible data and explain some doubts in this respect. [ABSTRACT FROM AUTHOR]

Background: Airway management is always of great concern for anesthesiologists especially in the prone position. Utilizing an Armored endotracheal tube is considered to be safe in such patients. Cases Report: In this current case, we introduce a patient undergoing a wake-up test during spinal surgery who suffered from hypoventilation at the end of surgery. His condition improved only after extubation. After extubation, we confronted a herniated cuff that was not deflated, although we tried twice. We concluded that the patient's respiratory effort against obstructed airway produced a negative pressure, which made the cuff herniated, resulting in airway obstruction. Moreover, the patient biting the tube during the wake-up test damaged the tube and cuff deflation pathway. Conclusion: It is important to consider cuff herniation as a cause of obstruction when other possible etiologies are ruled out. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to compare the effect of analgesia of Ropivacaine and magnesium sulfate as subcutaneous infiltration at the site of surgical cutaneous cholecystectomy in the postoperative period. Materials and Methods: To achieve the research goals, 80 patients referred to Shohada Tajrish Hospital in Tehran in 2016, which were randomly divided into two groups: Ropivacaine and magnesium sulfate. Patients in both groups had similar anesthetic procedures and all of them were monitored standard were recorded within 24 hours of operation. Overall morphine dose was also recorded for postoperative pain. Results: The findings showed that there was a significant difference between the two groups in the Ropivacaine group in the next hours despite the no significant difference in age, sex, BMI, duration of operation and pain scoring at first and third hours. In addition, the comparison of the number of requests for at least one dose of morphine in the Ropivacaine group is significantly lower. In addition, the comparison of the number of requests for at least one dose of morphine in the Ropivacaine group is significantly lower. The occurrence of PONV is also higher in the magnesium sulfate group, but this difference is not significant. Conclusion: Local injection of Ropivacaine reduced acute pain after open cholecystectomy surgery in comparison to local injection of magnesium sulfate. In addition, the use of Ropivacaine is associated with a significant reduction in the need for intravenous morphine for analgesia. [ABSTRACT FROM AUTHOR]

Background: Respiratory obstruction is a fatal complication following carotid endarterectomy, which caused direct compression of trachea secondary to venous and lymphatic congestion. Cases Report: In this study, we report a complicated case of carotid endarterectomy that required emergency intubation in difficult circumstance due to progressing hematoma and soft tissue edema. Conclusion: we report a case of hematoma and edema causing compromised airway following carotid endarterectomy (CEA), in which quick action to decompress the hematoma and prepare a secure airway lead to successful outcome. [ABSTRACT FROM AUTHOR]